Microsoft co-founder and philanthropist Bill Gates said on Thursday that it is “tragic” that global child mortality is set to rise for the first time this century — a reversal he links directly to severe cuts in international aid by wealthy Western nations.
Speaking to AFP in a video interview from Seattle, Gates said funding reductions by the United States, Britain, France and Germany have been “disproportionate” and are now undermining decades of progress on child survival and disease prevention.
According to the Gates Foundation’s annual Goalkeepers report, the number of children dying before the age of five is projected to rise to 4.8 million in 2025, an increase of 200,000 deaths compared to 2024. Aid to developing countries has dropped 27% this year, threatening global efforts against malaria, HIV, polio and other preventable diseases.
Gates noted that child mortality had fallen steadily from nearly 10 million annual deaths at the turn of the millennium. The sudden reversal, he said, represents a devastating setback.
US Aid Cuts and Musk’s “DOGE”
Gates was particularly critical of the United States, which he said has imposed the deepest reductions. He attributed much of the damage to fellow billionaire Elon Musk’s Department of Government Efficiency (DOGE), claiming that its rapid cuts to foreign assistance were “responsible for a lot of deaths.”
Earlier this year, DOGE abruptly halted grants from the US Agency for International Development (USAID), which has been dismantled since Donald Trump returned to the White House in January.
Describing the situation as “chaotic,” Gates said he has been urging President Trump to reverse the cuts:
“I’m talking to President Trump about encouraging him to restore aid so that it is at most a modest cut — I don’t know if I’ll be successful with that.”
Gates also expressed disappointment that the U.S. declined to renew its funding for Gavi, the global vaccines alliance he supports. He criticised U.S. Health Secretary Robert F. Kennedy Jr. for sending a video to Gavi’s fundraising event that repeated “extremely debunked and misguided views” discouraging childhood immunisations.
Although the Gates Foundation works with every U.S. administration, Gates said their views on vaccines are “essentially opposite” to Kennedy’s.
Europe’s ‘Disproportionate’ Cuts
Gates acknowledged that budgets across the developed world are under pressure but lamented that international aid is being targeted most aggressively.
He said he has spoken with leaders in France — including the prime minister and president — to urge them not to slash global health funding as the country finalises its budget.
“Please remember how important this is,” he said, even as he noted that France faces a “very tough budget situation.”
Long-Term Consequences: 16 Million More Child Deaths
If global aid cuts of roughly 30% remain permanent, modelling by the Institute for Health Metrics and Evaluation, funded by the Gates Foundation, projects that 16 million additional children could die by 2045.
“That’s 16 million mothers experiencing something no one should ever have to face,” Gates said.
Separate research from the Barcelona Institute for Global Health, reported exclusively by AFP last month, estimated that over 22 million people could die from preventable causes by 2030 due to US and European aid cutbacks.
Hope in New Vaccines and Medical Innovations
Despite the grim outlook, Gates expressed optimism that new health technologies could eventually reverse the rising trend.
He highlighted several promising breakthroughs:
New RSV vaccines
Improved pneumonia vaccines
Lenacapavir, a twice-a-year HIV-prevention injection now being rolled out in South Africa
Gates said such tools could help bring global child mortality down again within the next five years.
Gates’ Philanthropy and Growing Influence
The Bill & Melinda Gates Foundation, launched in 2000, remains one of the world’s largest private donors to global health. Melinda French Gates left the organisation in 2023 following the couple’s divorce.
In May, Gates announced plans to donate his entire $200+ billion fortune by 2045.
Jessica Sklair, a scholar of elite philanthropy at Queen Mary University of London, told AFP that Gates already holds enormous influence in the global health arena — a role that could grow further as governments shrink their aid budgets. However, she cautioned that private philanthropy alone is unlikely to replace the funding gap left by Western nations.